Supported by The Duke Endowment, the RCCP is completing a 5-year multi-site study of the CARE Model by analyzing data and writing papers to disseminate study outcomes. Additionally, the RCCP set up a series of Community of Practice regional events to share the new information with their CARE agencies, allowing agencies and the RCCP to not only learn from the research, but from one another in a collaborative way through discussion and networking.

One such Community of Practice regional event took place on August 12, 2015 at Waterford Country School in Connecticut. RCCP staff began by providing the context for the research. Specifically, Debbie Sellers (BCTR director of research and evaluation) gave a presentation explaining translational research (TR) and the RCCP approach to TR. Charlie Izzo (RCCP research associate) described the CARE Theory of Change, which outlines the change processes RCCP facilitates at each agency, and how these relate to the expected measurable outcomes.

Next, RCCP staff summarized the results from three related CARE studies. Charlie Izzo described the results of a study conducted across 11 agencies demonstrating that CARE implementation led to an average decline in three types of behavioral incidents: aggression toward staff, aggression towards peers, and property destruction. Izzo also presented findings from a study across 13 agencies demonstrating that CARE implementation led to a significant improvement in youth reports of the quality of their relationship with agency direct care providers. Finally, Michael Nunno co-presented with representatives from an experienced CARE agency about a study they conducted together. These findings replicated and extended the findings of the Duke study, demonstrating that CARE led not only to fewer behavioral incidents, but also fewer physical restraints and less frequent use of psychotropic medication.

The Connecticut audience was a diverse group, including agency administrators, program managers, and supervisors, as well as board members and those in research/evaluation roles. Of particular interest to attendees was the finding that as relationship quality improved, behavioral incidents decreased. This information would support, encourage and validate the efforts of front line staff.

Attendees were actively involved throughout the day in helping to clarify the interpretation and practical significance of the findings, and proposing future research directions that would help inform their efforts to implement CARE and better meet the needs of children and families. For example, during a discussion about their unique roles in implementing CARE, clinicians realized that they are a natural group to educate agency direct care staff about applying CARE principles in their daily work. RCCP staff is incorporating this clinician input into a tool in development that measures implementation quality across agency sectors. Agency clinicians also stimulated discussion about developing a tool to specifically assess practices that clinicians use to strengthen CARE implementation and sustainability over time.

The day ended with a series of interactive small-group discussions about the essential elements within the CARE implementation process led by Lisa McCabe and Frank Kuhn that were most likely to lead to positive outcomes and long-term sustainability. The ideas generated through these discussions not only helped the CARE team refine its implementation processes, but also pointed the way toward several promising research questions.

William Martin, executive director for Waterford was particularly pleased with the opportunities that this event provided for his staff, “I want to say that being asked to host this event provided an opportunity for my staff that they never could have gotten any other way,” and that RCCP “continues to do things that change our lives here at Waterford Country School and I could not be more appreciative.”

Two additional Community of Practice regional events were held on May 20, 2015 in Statesville, NC and on October 15, 2015 in Brisbane, Australia.

The 13th European Scientific Association on Residential and Family Care for Children and Adolescents Conference (EUSARF) 2014 was held in Copenhagen, Denmark on September 2-5, 2014 and the BCTR's Residential Child Care Project (RCCP) was well represented. This conference is held biannually and presents an opportunity for researchers and practitioners from Europe and around the world to exchange and discuss the latest international research and practice in child and family care. The heading for this year’s conference was "Making a Difference," focusing on ways to translate positive experiences and outcomes into best practices that make a difference in the lives of vulnerable children and their families.

The RCCP's Michael Nunno, Martha Holden, Charlie Izzo, Frank Kuhn, Bill Martin, and Sharon Butcher presented a symposium on Implementing, Evaluating and Sustaining a Research and Principle-based Program Model in Residential Care with Children and Adolescents: Learning from the Cornell CARE Program Experience. During this 2-hour symposium, the RCCP faculty

gave an overview of the CARE model and implementation process

shared the preliminary results from the 4- year quasi-experimental study of 14 agencies implementing the CARE model

discussed the complexity of implementing a principled-based model in residential therapeutic care organizations

and used a single case study to illustrate the impact of CARE and the RCCP’s Therapeutic Crisis Intervention (TCI) System on one organization that has a range of services to children and families

The conference also saw the launch of a new book, Therapeutic Residential Care For Children and Youth: Developing Evidence-Based International Practice, edited by J. Whitaker, J. del Valle and L. Holmes (Jessica Kinsgley Publishers). Martha Holden, James Anglin, Michael Nunno, and Charlie Izzo wrote the chapter, Engaging the Total Therapeutic Residential Care Program in a Process of Quality Improvement: Learning from the CARE Model, contributing the effort to take an international look at the current practice in therapeutic residential care.

The Global Implementation Conference (GIC) was held in Washington DC on August 19-21, 2013. Several BCTR staff attended the conference and were on the program. The GIC provided a unique forum to share the latest information about implementation science, practice, and policy that supports organizational change, system transformation, and implementation in human services and other real-world settings. Participants from diverse backgrounds and settings gathered to share ideas and research. The 2013 GIC theme was Putting Implementation into Practice: Tools for Quality and Sustainability.